Hyperventilation and abdominal pain

A patient came to see me yesterday. She has had severe tummy aches which she was told were due to irritable bowel syndrome (IBS). They have been going on for months. We have already investigated the cause and know that there is nothing serious going on. The clue to her problem lies in the fact that the problems get much worse when she walks or exerts herself. They are also worse when she gets anxious.

I pointed out that some people tend to over-breathe when they are anxious or when they exercise. This leads to swallowing air which in turn causes the stomach to become distended or bloated and can give quite awful stomach aches.

As I told her this, her eyes lit up. ‘That is exactly what is happening to me’, she said. I recommended a course of physiotherapy to focus on breathing techniques. Retraining her to breathe more normally when exercising is likely to make a big difference to the terrible abdominal pain she suffers from. We shall have to wait and see!

Another female patient came with abdominal pain which may be exacerbated by opening her bowels. The clue to her problem was that the pains are worse around the time of her periods. An ultrasound scan revealed an ovarian cyst. Treating this has made her very much better and the pains have now gone away.

There are many different conditions which masquerade as irritable bowel syndrome. A careful history and appropriate investigations can make all the difference to the success of treatment.